title: Assessment of arterial stiffness for clinical and epidemiological studies: methodological considerations for validation and entry into the European Renal and Cardiovascular Medicine registry.
abstract: Epidemiological studies have highlighted the role of arterial stiffness as a risk factor for development of cardiovascular (CV) diseases. Moreover, aortic stiffness has been shown to be a significant predictive factor of all-cause and CV mortality in different populations including patients with end-stage renal disease. Pulse-wave velocity (PWV) is the most widely used technique to assess arterial stiffness. Although PWV can be measured on any artery or between any arterial sites, only carotid-to-femoral PWV, representing stiffness of the aorta and iliofemoral axes, has been shown to have predictive value for morbidity and mortality. The several available commercial devices differ according to the type of signal (pressure, distension, flow) or by recording both sites simultaneously or using ECG synchronization. It is also possible to directly measure arterial diameter changes during the cardiac cycle and link them to local pulse-pressure changes, which provides the pressure-diameter relationship and stress-strain relationship if arterial wall thickness is also measured. These techniques are based on high-precision vascular echo tracking or magnetic resonance imaging and applanation tonometry. This paper summarizes the basic principles of arterial haemodynamics and various methodologies to assess stiffness and the latest consensus recommendations for clinical applications.
authors.affiliation: Hopital Européen Georges Pompidou, Assistance Publique, Université Paris Descartes, Hôpitaux de Paris, Paris, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Boutouyrie
authors.forename: Danilo
authors.initials: D
authors.lastname: Fliser
authors.forename: David
authors.initials: D
authors.lastname: Goldsmith
authors.forename: Adrian
authors.initials: A
authors.lastname: Covic
authors.forename: Andrzej
authors.initials: A
authors.lastname: Wiecek
authors.forename: Alberto
authors.initials: A
authors.lastname: Ortiz
authors.forename: Alberto
authors.initials: A
authors.lastname: Martinez-Castelao
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Massy
authors.forename: Gultekin
authors.initials: G
authors.lastname: Suleymanlar
authors.forename: Rosa
authors.initials: R
authors.lastname: Sicari
authors.forename: Luna
authors.initials: L
authors.lastname: Gargani
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.forename: Francesca
authors.initials: F
authors.lastname: Mallamaci
authors.forename: Carmine
authors.initials: C
authors.lastname: Zoccali
authors.forename: Gerard M
authors.initials: GM
authors.lastname: London
mesh_terms: D001158:Arteries / Q000503:physiopathology*; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D016021:Epidemiologic Studies; D005060:Europe / Q000453:epidemiology; D006801:Humans; D007676:Kidney Failure, Chronic / Q000453:epidemiology / Q000503:physiopathology*; D012042:Registries; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D059289:Vascular Stiffness / Q000502:physiology*
keywords: aortic pressure; arterial stiffness; elastic modulus; pulse-wave velocity